KMuniz

Guys, do you have patients who would call your clinic to ask you to call them back in between the visits? To change the dose of the medications, etc. They want a call back instead of a Dr. visit...how do you charge these patients? If you charge for collateral services as a telephone call I am assuming it's less than a visit in the office...I am not sure if this is common practice, but I have noticed a pattern where I work, or maybe they take advantage of me:) Thanks!

THANK YOU SO MUCH, your answer helps a lot and I appreciate you for taking the time to answer!! I feel so much better! ?

"You make more doing 30 min appts and then only see about 12 to 14 a day max. Add on codes for therapy for two 30 min appts per hour are worth more than trying to do 3 med checks in an hour and much mess stressful." Do you mind me asking what charge codes do you use for visit + therapy? Is it 90836 or 90838? Like I did have a complex new patient w/previous 4 meds, 4 dx spent over 1 hr; I can charge for supportive therapy since I did provide that, and then how much time I put? Do I add the therapy to the 60 min that I already have for new patient? Thanks in advance!! E.G. 90204 + 90838? Would be that what I should do? And when do you charge under 90205? Is it only when you would need to send someone for higher care level such as hospital?

Hi! Would you like to share what you get paid so we all get an idea? I work in Houston, Texas, 52% cut , which is extremely low, working part-time making $2,500/month seeing 50-55 patients/month. Yes, I don't work much but the pay discourages me...I cannot imagine working full time which means 20 patients/day, lots of stress, cannot imagine how people can handle this. I am new to PMHNPs field, you can tell:) Thanks everyone!

Hi! I was curious to hear from other PMHNP who want to share their experiences as PMHNP. I have been working for about 6 months in private practice in Houston area, but I feel like "It's a promised land"...no good pay, get 52% of what they bill they say, want you to see patients every 20 min (and check T, BP, open your note, schedule the next visit for the ones seen, DON'T make the pt wait) which in my opinion, is very stressful, and besides you always have to reply to patient's messages through Klara or emails, write referral letters or different letters that the patients ask you to. It looks like I put more hours (after work hours) that I thought only to reply or finish charting. Patients always ask you to refill meds between the visits, etc. As a part-time PMHNP I make about $2,500 seeing around 50-55 patients in a month; I see kids too, which is like ouble work as I talk to the child then I start all over w/the parent... NPs in the office see 15-20 patients/day, and I cannot imagine this workload, and I am not sure how much they make, but to me it's like they all take work home. I appreciate you sharing your experience!

Hi! Can a Psychiatric nurse practitioner practice independently? Do we need first the RN endorsed then the NP license? I am new in the process...Can't figure out if they want the RN license first or they endorse the APN...I am licensed in Texas, intending to move to get California Psych Nurse Practitioner license as well. Thanks!

Hi! Great advice here from the fellow successful people, THANK YOU! I passed today, I am very happy just like you, the ones who passed!! Let me tell you my opinion and what I did. First, I need to say that I am an immigrant (came to North America about 18 years ago), have 0 experience in Psych, only the psych course in school more than 15-16 years ago...just to give you an idea where I am coming from...worked as a wound care specialist, then school nurse...and decided to change my career for something that I have always been attracted to-psychiatry. I need to tell you, THIS BOARD EXAM IS HARD! Don't want to scare anyone, if I passed you will to!! But, don't take it lightly, study hard, do your best every day you are in school and when you prepare. It's no joke, it's serious, and you need to use a lot of knowledge to pass it. I took 2 months to prepare after I was done with my program and I did the purple book (the questions at the back 2,3 x until I got almost 100%), Fitzgerald review about 2x (listening in the car as well); Questions from Study pocket prep (800 questions-good one, worth the money) and the ANA PMHNP certification practice IQ course. Did these questions prepare me?? Probably...but they were totally different...case scenarios, clinical judgement + a lot of clear cut knowledge that you must have (Erickson stages, CIWA, COWS, PHQ-9, SBIRT, yes, know the scores, lab values, meds, delirium, dementia, therapies, stuff like that, thyroid problems, clear knowledge). I did study probably 2-4 hrs/a day the most on some days, and some days I was not studying at all. Work full time job M-F, have two kids, you get the picture...If I look back, yes, I wish I would have studied harder and take it more seriously. I was scoring initially 60-70% the most on those practice questions, look at the rationale, an retake them for a 90-100% the 2 nd time. Not sure how much these really prepared me, but it's all about studying all the time, and knowing that this board exam is challenging!! I was very confident before the test, but as I was taking it I was doubting my answers (except a few that were straightforward, about 10 maybe) and by the end of it I was mentally prepared that I might need to retake it in 3 months... Not a nice thought...So, to spare yourself from going thru this, study hard from the beginning, every day, start early BEFORE you finish the program with practicing questions (I have learned from some colleagues that they started 6-10 mths prior, I wish I knew that...), and know that it is challenging and all those practice questions that we are doing are most likely not going to be on the real exam, but they do make you get an idea on what to focus and what the real ones look like. I wish everyone GOOD LUCK!! You will do fine with the right preparation!!

Hi, Any updates on how the FNP program is going? I am considering it for fall 2018 but the fact that they are not accredited worries me a little, and how much would you spend on books for a year? if anyone can tell me this...on top of the $18,000...Thank you!!

Hi, I am new in wound care/RN. I am asked to administer moderate sedation when the dr. debrides on wounds. I do not know if this is something that usually RN wound care nurse needs to do. I do not feel comfy by giving it since I've never been asked to do it in my career/10 y nursing experience in diferent settings. Thank you, I appreciate your replies.